Bill H.1942
188th (2013 - 2014)

An Act relative to office-based surgery

Bill Title: An Act relative to office-based surgery

By Ms. Dykema of Holliston, a petition (accompanied by bill, House, No. 1942) of Carolyn C. Dykema and others relative to the accreditation of offices performing office-based surgery operated by a licensed health care provider or organization. Public Health.

SECTION . Chapter 111 of the General Laws is hereby amended by adding the following section:-
Section 230. (a) For the purposes of this section the following terms shall have the following meanings:-
"Deep sedation/ analgesia", a drug-induced depression of consciousness during which patients cannot be easily aroused but respond purposefully following repeated or painful stimulation. The ability to independently maintain ventilatory function may be impaired. Patients may require assistance in maintaining a patent airway, and spontaneous ventilation may be inadequate. Cardiovascular function is usually maintained.
"General anesthesia", a state of unconsciousness intentionally produced by anesthetic agents, with absence of pain sensation over the entire body, in which the patient’s protective airway reflexes may be impaired and the patient may be unable to maintain a patent natural airway. Sedation that unintentionally progresses to the point at which the patient’s protective airway reflexes are impaired and the patient is unable to maintain a patent natural airway is considered general anesthesia.
"Moderate sedation/ analgesia", a drug-induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by tactile stimulation. No interventions are required to maintain a patent airway, and spontaneous ventilation is adequate. Cardiovascular function is usually maintained.
"Office-based surgery", any surgery or invasive medical procedure requiring analgesia or sedation, when performed in a location other than a hospital or hospital associated surgical center.
(b) Any office performing office-based surgery operated by a licensed health care provider or organization at which moderate sedation/analgesia, deep sedation/analgesia or general anesthesia is administered shall be accredited by at least one of the following entities: (1) The Medicare program; (2) the Accreditation Association for Ambulatory Health Care; (3) the American Association for Accreditation of Ambulatory Surgery Facilities, Inc.; (4) the Joint Commission on Accreditation of Healthcare Organizations; or (5) any other nationally recognized accrediting agency approved by the board of registration in medicine. Such accreditation shall be obtained not later than 18 months after July 1, 2014, or 18 months after the date on which moderate sedation/analgesia, deep sedation/analgesia or general anesthesia is first administered at such office or facility, whichever is later. Upon the expiration of the applicable 18 month period, no moderate sedation/analgesia, deep sedation/analgesia or general anesthesia may be administered at any such office or facility that does not receive accreditation as required by this section.
(c) Evidence of such accreditation shall be maintained at any such office or facility at which moderate sedation/analgesia, deep sedation/analgesia or general anesthesia is administered and shall be made available for inspection upon request of the department.
(d) The board of registration in medicine may revoke, suspend or deny renewal of the license of a practitioner who violates this section.

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